Evidence map›Paper›PMID 41716216›Full record

ArticleJHLT open2026

Risk factors when considering heart transplants with donors aged 45 or above: Development of a Novel Mortality Risk Score using UNOS data.

Anh Nguyen, Abbas Rana, Alexis Shafii, Gabriel Loor, Andrew Civitello, Todd Rosengart, Kenneth Liao

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Article in JHLT open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Anh NguyenDivision of Cardiothoracic Transplantation and Circulatory Support, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Abbas RanaDivision of Abdominal Transplantation, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Alexis ShafiiDivision of Cardiothoracic Transplantation and Circulatory Support, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Gabriel LoorDivision of Cardiothoracic Transplantation and Circulatory Support, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Andrew CivitelloDivision of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Todd RosengartDivision of Cardiothoracic Surgery, Department of Surgery, Baylor College of Medicine, Houston, Texas.
Kenneth LiaoDivision of Cardiothoracic Transplantation and Circulatory Support, Department of Surgery, Baylor College of Medicine, Houston, Texas.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Current International Society for Heart and Lung Transplantation guidelines support the use of donor hearts aged ≥45 if significant coronary artery disease is excluded and ischemic time remains <4 hours. This study aimed to identify additional risk factors affecting patient survival and develop a risk score for recipients of older donor hearts. Methods: We performed a retrospective cohort study of adult heart transplants using donors aged ≥45 from January 2000 to June 2024, using United Network for Organ Sharing data. Multivariable Cox regression identified risk factors for mortality, and the most significant variables were used to construct a risk score. Results: Of 58,859 adult heart transplants, 9,843 (16.7%) involved donors aged ≥45. Recipient median age was 58 years (interquartile range, 51-64). One-, 5-, and 10-year patient survival rates were 87.0%, 73.3%, and 53.5%, respectively. Statistically significant risk factors included ischemic time ≥4 hours (HR = 1.11), cytomegalovirus (CMV)-positive donor status (hazard ratio [HR] = 1.11), donor cigarette use (HR = 1.10) and recipient factors: age >55 (HR = 1.37), Black race (HR = 1.19), obesity (HR = 1.20), diabetes (HR = 1.27), pretransplant dialysis (HR = 1.44), pretransplant mechanical ventilator use (HR = 1.37), and prior cardiac surgery (HR = 1.28). Model discrimination was moderate with C-statistics of 0.58. Conclusions: When considering heart transplants with donors aged ≥45, we should screen for ischemic time ≥4 hours, CMV-positive donor, donor cigarette use, and the following recipient factors: age >55, Black race, obesity, diabetes, pretransplant dialysis or mechanical ventilation, and prior cardiac surgery.

Indexed as

donor ageheart transplantmortalityrisk scoresurvival

Identifiers

PMID41716216
PMCPMC12914790

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.